Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Achievement Motivation

It is clear that some injured workers will return to work in great pain while others with lesser pain elect never to return to work. There is a way to predict who will do what.

Achievement motivation can arise from several sources, but the two most common are:

* Fear of financial destitution and its effect upon patient and family And/or* Perceptions of having a focused career

Those who believe that their job entails their _life_s work,_ that it defines who they are, that there identity and that of their coworkers is contingent upon quality work completion are more likely to return to work_in pain and with limitations. So, it is imperative that it be determined if this patient_s job established for him/her a particular role in their society.

Equally as important, if the patient perceives that some/any form of employment is mandatory in order to maintain the financial functioning, if not survival, of family and self, he/she has a higher probability of returning to productivity. This, it is equally imperative to determine if this patient is experiencing financial concern or whether the combination of compensation and spouse returning to work does not meet or exceed what the patient was earning when working.

In summary, the patient who feels minimal financial pressure and who was largely indifferent to what type of job he/she was performing is the least likely to return to work. We need those data as soon as they can be obtained.